International Journal of Preventive Medicine
Volume:3 Issue: 5, May 2012

This study aims to review the economic cost of childhood (0-18 years) unintentional injuries (UI) and focuses upon comparing the cost burden between developing and developed countries. Articles were selected from PUBMED using the search words “Economic Cost”, “Unintentional injuries” and “Children”. Nine articles were selected. Studies in China focused upon cost to hospitals, in Bangladesh they focused on personal payment in rural areas, and in Vietnam they focused upon community-based cost analysis. There was one study from Norway on UI at home. There were 5 articles from the USA focusing on submersion injury, UI insurance, unintentional traumatic brain injury, UI due to firearms and UI medical costs. The cost of childhood UI is enormous, ranging from US $516,938 to US $9,550,704 per year. This represents a large economic burden on society. Additionally, there is a large gap between lower-middle income countries (LMIC) and high income countries (HIC) in the burden of injury, injury health care and insurance systems. Different bases and contexts of studies make it difficult to draw a solid conclusion about the amount of costs of UI among children. Therefore, more studies of children’s unintentional injuries should be carried out in low and middle income countries.

The onset of multiple sclerosis in the majority of the cases occurs as a clinically isolated syndrome (CIS). We sought to assess serum levels of 25-hydroxyvitamin D (25-OHD) in CIS patients and healthy controls. In this cross-sectional study 40 patients (36 women and 4 men) with CIS manifesting as a single isolated optic neuritis and 40 Age- and sex-matched healthy controls (35 women and 5 men) were enrolled between late October 2010 and early March 2011. General vitamin D deficiency was defined as serum 25-OHD levels of lower than 20 ng/ml and was classified as mild (15 < 25-OHD <20 ng/ml), moderate (8 < 25-OHD <15 ng/ml), and severe (25- OHD <8 ng/ml). We found no difference in the median interquartile range [IQR] between CIS patients and controls (17.95 [10.40- 29.13] vs. 17.00 [12.25-31.00]; P=0.57). However, when stratified by the levels of deficiency, among CIS patients a significantly higher proportion had severe vitamin D deficiency in comparison to healthy controls (20% vs. 2.5%; P=0.034). Nevertheless, the frequency of general (62.5% vs. 60%, P=0.82), mild (25% vs. 30%, P=0.80), and moderate (17.5% vs. 27.5%, P=0.42) vitamin D deficiency were not different between the two groups. Our findings do not indicate any significant difference of serum 25-OHD between CIS patients and healthy controls. However, in our series severe vitamin D deficiency was more frequent among CIS patients.

The purpose of this study is to determine association between personal, family, neighborhood, and social network characteristics and perceived intimacy in the neighborhood by the women. In this cross‑sectional study, we applied a two‑stage sampling method to choose a representative sample of 150 married women and housewives, aged 15 to 49 years, who had education between six and twelve years and lived in the urban areas of the Khorasan‑e‑Razavi province of Iran. Association between personal, family, neighborhood, and social network variables, with the perceived neighborhood intimacy, was assessed through univariate and multiple linear regression. Based on the multiple model, there were significant associations between neighborhood intimacy as perceived by the women and their education level (Standardized Beta=‑0.190, P=0.019), length of residence (Standardized Beta=0.175, P=0.029), self‑rated health status (Standardized Beta=0.177, P=0.029), and their individual social network size (Standardized Beta=0.211, P=0.030). The potential predictors including length of residence, self‑rated health, and size of the respondents’ personal social networks had a direct association with the women’s perceived neighborhood intimacy, while the education level of the respondents had an inverse association with the neighborhood intimacy, as another potential predictor. Neighborhood intimacy could express the social health condition of the community members.

Visfatin is a new adipocytokine which is largely secreted by visceral adipose tissue and its effects in the development of diabetes and inflammatory reactions are similar to insulin. It acts synergistically with insulin in increasing glucose cellular uptake, stimulating glucose transfer to the muscle and adipose tissue, as well as in preventing hepatic glucose production. Its insulin-like effects are mediated through direct connection and activation of insulin receptors without any change or competition with the insulin. This case-control study was conducted among 64 women consisting of 32 diabetic patients, and 32 age-matched healthy controls. The case group consisted of 32 post-menopausal diabetic women, aged 45-65 years. Those patients were eligible who had a history of at least five years of type II diabetes, without any complications of diabetes, and who were treated only by oral glucose-lowering medications. Those individuals with C-reactive protein (CRP) test of 3+ and above were excluded from the study. Results were compared with age- and sex- matched controls. Average visfatin level was significantly higher in diabetic patients than in controls (4.3 ± 1.06ng/dl vs. 3.15 ± 0.74ng/dl, respectively< 0.001). The mean values of anthropometric indexes and lipid profile were not significantly different between diabetic patients and controls. This study documented an inverse relationship between circulating level of visfatin and fasting blood glucose. This finding may suggest the role of increased visfatin level and increase in synthesis and secretion of the cytokines from adipocytes. These findings may be useful for primary and secondary preventive issues in diabetic and pre-diabetic individuals.

in children. Although its burden is considerably preventable by vaccine, routine vaccination against Hib has not been defined in the National Immunization Program of Iran. This study was performed to assess the cost-benefit and cost‑utility of running an Hib vaccination program in Iran. Based on a previous systematic review and meta‑analysis for vaccine efficacy, we estimated the averted DALYs (Disability adjusted life years) and cost‑benefit of vaccination. Different acute invasive forms of Hib infection and the permanent sequels were considered for estimating the attributed DALYs. We used a societal perspective for economic evaluation and included both direct and indirect costs of alternative options about vaccination. An annual discount rate of 3% and standard age‑weighting were used for estimation. To assess the robustness of the results, a sensitivity analysis was performed. The incidence of Hib infection was estimated 43.0 per 100000, which can be reduced to 6.7 by vaccination. Total costs of vaccination were estimated at US$ 15,538,129. Routine vaccination of the 2008birth cohort would prevent 4079 DALYs at a cost per averted‑DALY of US$ 4535. If we consider parents’ loss of income and future productivity loss of children, it would save US$ 8,991,141, with a benefit‑cost ratio of 2.14 in the base‑case analysis. Sensitivity analysis showed a range of 0.78 to 3.14 for benefit‑to‑cost ratios. Considering costs per averted DALY, vaccination against Hib is a cost‑effective health intervention in Iran, and allocating resources for routine vaccination against Hib seems logical.

To evaluate the reliability, validity and feasibility of the Persian version of the Pediatric Quality of Life inventory (PedsQL™ 4.0TM 4.0) Generic Core Scales in Iranian healthy students ages 7-15 and chronically ill children ages 2-18. We followed the translation methodology proposed by developer to validate Persian version of PedsQL™ 4.0TM 4.0 Generic Core Scales for children. Six hundred and sixty children and adolescents and their parents were enrolled. Sample of 160 healthy students were chosen by random cluster method between 4 regions of Isfahan education offices and 60 chronically ill children were recruited from St. Alzahra hospital private clinics. The questionnaires were fulfilled by the participants. The Persian version of PedsQL™ 4.0TM 4.0 Generic Core Scales discriminated between healthy and chronically ill children (healthy students mean score was 12.3 better than chronically ill children, P<0.001). Cronbachs’ alpha internal consistency values exceeded 0.7 for children self reports and proxy reports of children 5-7 years old and 13-18 years old. Reliability of proxy reports for 2-4 years old was much lower than 0.7. Although, proxy reports for chronically ill children 8-12 years old was more than 0.7, these reports for healthy children with same age group was slightly lower than 0.7. Constructive, criterion face and content validity were acceptable. In addition, the Persian version of PedsQL™ 4.0TM 4.0 Generic Core Scales was feasible and easy to complete. Results showed that Persian version of PedsQL™ 4.0TM 4.0 Generic Core Scales is valid and acceptable for pediatric health researches. It is necessary to alternate scoring for 2-4 years old questionnaire and to find a way to increase reliability for healthy children aged 8-12 years especially, according to Iranian culture.

Acute pancreatitis is an inflammatory condition of pancreas with sudden onset, high mortality rate and multiple organ failure characteristics. It has been shown that oxygen free radicals have an important role in development of pancreatitis and its complications. Antioxidant, anti-inflammatory, anti-hepatotoxicity and gastroprotective properties of Cichorium intybus L. suggest that this plant may have beneficial effects in the management of acute pancreatitis. Five intraperitoneal (i.p.) injection of cerulean (50 μg/ kg at 1 h intervals) in mice resulted in acute pancreatitis, which was characterized by edema, neutrophil infiltration, as well as increases in the serum levels of amylase and lipase in comparison to normal mice. Different doses of C. intybus root (CRE) and aerial parts hydroalcoholic extract (CAPE) orally (50, 100, 200 mg/kg) and intraperitoneally (50, 100, 200 mg/kg) were administrated 1.0 and 0.5 h respectively before pancreatitis induction on separate groups of male mice (n=6). Control groups treated with normal saline (5 ml/ kg) similarly. Both extracts in greater test doses (100 mg/kg and 200 mg/kg, i.p.) were effective to decrease amylase (23-36%) and lipase (27-35%) levels. In oral route, the dose of 200 mg/ kg showed a significant decrease in levels of amylase (16%) and lipase (24%) activity while the greatest dose (200 mg/kg, i.p.) was only effective to diminish inflammatory features like edema and leukocyte infiltration in pancreatitis tissue (P<0.01). Vacuolization was not significantly reduced in extracts treated groups. These data suggest that C. intybus hydroalcoholic extracts were effective to protect against experimental acute pancreatitis and the efficacy was partly dependent to the dose and was more significant after parenteral administration.

To evaluate the possible interaction between religious beliefs and psychiatric disorders among Black Americans. In this study, we used data of 5181 adult Black Americans who had participated in National Survey of American Life (NSAL) from February 2001 to June 2003. Variables such as socio-demographics, religious beliefs, and psychiatric disorders were entered in a Cox regression to determine the possible interaction between psychiatric disorders (0, 1, ≥2) and the subjective religiosity on age of onset of suicidal thought among the participants. Main outcome was age of the first serious suicidal ideation. A dose-dependent effect of number of psychiatric disorders on suicidal ideation was observed. Psychiatric disorders had a higher impact on age of suicidal ideation among those with low self-reported religiosity. Religious beliefs may buffer the effect of psychiatric disorders on suicidal thought. Blacks who are less religious and suffer psychiatric disorders are at the highest risk for early suicidal ideation.

Non communicable diseases (NCD) will account for 73% of deaths and 60% of the global disease burden by 2020. Physical activity plays a major role in the prevention of these non‑communicable diseases. The stress involved in meeting responsibilities of becoming a physician may adversely affect the exercise habits of students. So, the current study aimed to study the practice of physical activity among undergraduate medical students. A cross sectional study was conducted among 240 undergraduate medical students. Quota sampling method was used to identify 60 students from each of the four even semesters. A pre‑tested, semi‑structured questionnaire was used to collect the data. Statistical Package for Social Sciences (SPSS) version 16 was used for data entry and analysis and results are expressed as percentages and proportions. In our study, 55% were 20 to 22 years old. Over half of the students were utilizing the sports facilities provided by the university in the campus. Majority of students 165 (69%) had normal body mass index (BMI), (51) 21% were overweight, while 7 (3%) were obese. Of the 62% who were currently exercising, the practice of physical activity was more among boys as compared to girls (62% v/s 38%). Lack of time 46 (60.5%), laziness (61.8%), and exhaustion from academic activities (42%) were identified as important hindering factors among medical students who did not exercise. A longitudinal study to follow‑up student behavior throughout their academic life is needed to identify the factors promoting the practice of physical activity among students.

Strongyloidiasis is a disease characterized by a diverse spectrum of unspecific manifestations that complicate its diagnosis. Although, the course of its chronic form is usually benign, in cases of immunosuppression, iatrogenic or not, it can evolve to a hyperifection syndrome with even fatal complications. Herein, we report a case of Strongyloides stercoralis hyperinfection in a Greek patient receiving corticosteroid treatment for chronic eosinophilia and angioedema. The case represents an extremely rare case of autochthonous strongyloidiasis in Greece and underlines the importance of the early diagnosis of the disease’s uncomplicated forms in order to prevent its severe sequelae.

Peri-ampullary and pancreatic head cancer can cause significant morbidity and mortality among gastrointestinal malignancies in human beings because of its important anatomy and physiology.[1] This tumor is responsible for about 150,000 deaths annually all over the world, and is categorized as the 5th leading causes of death among the malignancies. [2] Pancreaticoduodenectomy (PD) is the complex palliative procedure for patients affecting peri-ampullary and pancreatic head tumors, benign neoplasm and for other conditions such as chronic pancreatitis showing obstructive jaundice as a common symptom, which was first time invented by Whipple et al.[3-7] Despite best palliative and occasionally curativeness of this procedure, there are some contraindications for the surgery including: Metastasis to distant organs, tumor infiltration to mesenteric and portal vessels and affecting small bowel mesentery by tumoral mass.[8]

In the present study conducted at a tertiary care level during the period from 2000-2009, the proportion of birth weight (≥2.5 kg) of new born babies was 80.8%, low birth weight (<2.5 kg) of new born babies was 19.2%. Of the new born babies, proportion of very low birth weight (<2 kg) was 6.9%. In this study, sex wise difference in the proportion of low birth weight new born babies was not significant. But, significant difference occurred in the proportion of newborn babies with weight ≥2.5 kg (P=0.0001). It indicates that the proportion of males with weight ≥2.5 kg was more compared to females. The proportion of low birth weight of new born babies from 2000-2001 to 2008-2009 was increased from 17.8% to 25.09% (P<0.0001). At the same time, the proportion of new born babies with weight ≥2.5 kg was decreased from 82.2 to 69.8% (P<0.0001). Birth weight is one of the most important factor for estimating the maturity of the newborn, evaluating intrauterine growth and development. [1] This study indicates that low birth weight is very alarming. In both, the developed and developing countries low birth weight is the most important factor that affects perinatal mortality, neonatal mortality, postnatal mortality, infant mortality and infant and childhood morbidity.[2] A study of UNICEF reveals that incidence of low birth weight. In Bangladesh 30%, India 26%, Pakistan 21% and Sri Lanka 25% of new born babies have a high incidence of low birth weight.[3] In India, NFHS reported that the proportion of low birth weight babies about 23% for rural and 19% for urban population.[1] The proportion of low birth weight babies in Kerala study was found to be 18% in the year 1997.[4] NFHS data[1] shows that birth weight is influenced in many socio-economic factors like urban or rural, education, birth order, tobacco use by mother, wealth, religion and caste. In the present study and all other studies mentioned above showed that low birth weight is increasing. Our attention is to concentrate towards how to improve the nation from the fearful unhealthy conditions. Unhealthy people will produce unhealthy nation and it will also affect the development of the nation. Early marriage, early child bearing and nutritional deficiency are the causes of low birth weight. Save the nation from the terrible conditions by conducting health education, awareness programmes, improve the antenatal care and by taking suitable measures. Buildup a healthy people and save Nation.